Affiliations: [a] Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| [b] Center for Experimental Medicine & Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| [c] Department of Neurology, Klinikum Ernst von Bergmann, Potsdam, Germany
| [d] Institute of Neuroimmunology and Multiple Sclerosis (INIMS), Center for Molecular Neurobiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Correspondence:
[*]
Correspondence to: Dr. Odette Fründt, Department of
Neurology, Klinikum Ernst von Bergmann, Charlottenstraße 72,
14467 Potsdam, Germany. Tel.: +49 331 241 37102;
E-mail: odette.fruendt@klinikumevb.de.
Note: [1] These authors contributed equally to this work.
Abstract: Background:Based on data regarding the prevalence of Parkinson’s disease (PD), the prevalence of impulsive control disorders (ICD) in PD, and the percentage of PD patients driving a car, it has to be assumed that at least 50,000 PD patients with ICD in Germany actively drive a car. However, these patients might be at risk for unsafe driving due to ICD-related dysfunctions such as failure to resist an impulse or temptation, to control an act or other altered neurobehavioral processes. Objective:This study determines the influence of ICD on driving ability in PD. Methods:We prospectively compared driving simulator performance of 23 PD patients with and 23 matched patients without ICD. ICD had to be socially compensated and presence was defined clinically for primary and questionnaire-based (QUIP-RS) for post-hoc analyses. Furthermore, between-group comparisons of driving-relevant neuropsychological tests were executed. Results:Except from a lower blinking frequency when changing lanes, overall driving safety of patients with ICD did not differ significantly from those without—regardless of the clinical or QUIP-RS-based ICD definition. ICD severity did not correlate with driving performance, but the latter correlated significantly with mean reaction times and certain neuropsychiatric tests (MoCA, TMT-A, TAP-M “flexibility” and DBQ “error”). Conclusion:Clinically compensated ICD does not seem to impair driving safety in PD patients. Rather, cognitive and attentional deficits appear to be clinical markers for driving uncertainty.
Keywords: Parkinson’s disease, impulse control
disorders, car driving, driving safety
